A 53-year-old woman presented with dyspnea. She had undergone extended thymectomy for an invasive thymoma two months prior. CT revealed numerous small nodules in the lung. After that, she deteriorated owing to acute respiratory distress syndrome (ARDS), and the vascular surgeon planned veno-venous extracorporeal membrane oxygenation (ECMO). During percutaneous cannulation through the left femoral vein, a vascular injury was suspected, and the patient’s vital signs became unstable. Diagnostic angiography showed a ruptured left common iliac vein, and the bleeding was stopped by placement of a stent-graft. May-Thurner syndrome was diagnosed on abdominal CT. Here, we report a rare case of ECMO-related vascular injury in a patient with an unrecognized anatomical variant, May-Thurner syndrome.

No abstract available.
Angiofibroma*

No abstract available.
Malaria*

PURPOSE: Acute scrotal pain is one of the most alarming urologic symptoms, concealing testicular inflammation, testicular torsion, torsion of testicular appendix and a variety of miscellaneous diseases. Even with careful physical examination with recently developed diagnostic equipments, a reliable diagnosis may not be achieved in a significant number of patients. In these cases an operation is necessary for exclusion of testicular torsion. MATERIALS AND METHODS: Between 1991 and 1998, we reviewed 17 patients diagnosed as having torsion of testicular appenix, whose ages varied from 3 years to 15 years during recent 8 years. RESULTS: 16 cases out of seventeen patients(94%) were younger 12 years and prevalent age was 11 years(6/17). The average interval that elapsed from onset of symptoms until the patient was seen for the first time on the hospital was 64 hours, with a range varying from three hours to seven days. The most frequently observed symptoms and signs were diffuse scrotal pain, swelling and erythema of the affected scrotum. The explorative scrototomy were performed in 16 cases out of 17 patients who had appendix testis torsion, and the 1 case had conservative treatment after getting confirmative diagnosis by ultrasonography. The scrotal pain disappeared mostly within 1 day after operation, and the complications didn`t happen. CONCLUSIONS: There is controversy as whether the majority of children with torsion of the testicular appendix develop sufficiently grave symptoms to justify the surgical exploration. For this reason, once a diagnosis of torsion of the spermatic cord is ruled out, some investigators prefer conservative treatment. However, differential diagnosis with torsion of the spermatic cord is difficult and acute scrotal pain disappear within 24hours after excision of the twisted appendix. Therefore, we are in favor of surgical treatment.
Appendix* ; Child ; Diagnosis ; Diagnosis, Differential ; Diagnostic Equipment ; Erythema ; Humans ; Inflammation ; Physical Examination ; Research Personnel ; Scrotum ; Spermatic Cord ; Spermatic Cord Torsion ; Testis ; Ultrasonography

No abstract available.
Fungi* ; Plastics*

No abstract available.
Ear* ; Papain*

No abstract available.
Hemarthrosis* ; Knee*

Urinary incontinence is an annoying complaint in patients with imbalanced upper motor neuron lesion, and prevention of vesicoureteral reflux and urinary tract infection is important for the preservation of renal function. We present two cases of autoaugmentation cystoplasty and extravesical ureteral reimplantation (Lich-Gregoir Technique) in paraplegics who have upper motor neuron lesion with vesicoureteral reflux.
Humans ; Motor Neurons ; Muscle Spasticity* ; Replantation ; Ureter ; Urinary Bladder, Neurogenic* ; Urinary Incontinence ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

Metastatic renal cell carcinoma is common, but dissemination to the gallbladder is extrem-ely rare. The patient was diagnosed as having distal CBD stone and renal cell carcinoma before she underwent operation, but postoperative pathologic examination revealed clear cell type renal cell carcinoma within the gallbladder. We report a case of renal cell carcinoma with synchronous metastasis to the gallbladder.
Carcinoma, Renal Cell* ; Gallbladder* ; Humans ; Neoplasm Metastasis

Pneumorrhachis, which involves the entrapment of air or gas within the spinal canal, is a rare clinical entity, and the pathogenesis and etiologies of this uncommon entity are various and can present a diagnostic challenge. Usually, pneumorrhachis represents an asymptomatic epiphenomenon but it can produce symptoms associated with its underlying pathology. Here, we report a rare case of symptomatic epidural pneumorrhachis accompanying pneumothorax. Possible pathogenic mechanisms are discussed and a review of the literature is included.
Pneumorrhachis ; Pneumothorax ; Spinal Canal